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08040044CITY OF CUPERTINO BUILDING DIVISI')N PERMIT yV� 1CM T� Z=tx•>� `� � "9WVE DR CUPERTINO PLUMBING ia PU8040044 . OWNER'S NAME: PERMIT ISSUE DATE ECKSTEIN BRUCE E 1300 DELL AVE STE C 04/07/2008 ONE: SANITARY NO. CONTROL NO. (408)253-0618 ARCHMCT(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 1= o 0 0 LICENSED CONTRACIDR'S DECLARATION Job DOSCrIpI100 Iion7"ffinndwl.mfthe Homed En under In"WMProl.W.-no or Cbaper9(mmmoming MN Section 7011U) of DiHnion Sof the Budneas and RoPoYiov Cads, and my license u COPPER REPIPE/WTR MAIN/WTR HEATER !A'U' fulfaux and ellen. (J Ucense Lk. . Datad/ — 04 ComrYaor .q ARCHReCrS DECLARATION I understand my plans shall be wed As public records _ Licensed Prefco l OWNER -BUILDER DECLARATION I hereby olirm that I am exempt from the Contractor's License Law for the following mason. (Section 703 LS, Business and Pmfc.Yinns Code: Any city or county which requires a permit w COCCUO . tiler, narrow, demolish, or repair my structure prior in its Issuance. ala octal. the mplicant (branch permit an file a signed suemoni 10 am C°nuxmr'° Umnx Law(CamUn 9 Sq. Ft. Floor Area Valuation t1u he is lhccvcd pumum the provisions Or $5000 (commeming with Section 7000) of Dlvtsion 3 of the Business and profound.. Code).1 1 that he Is AYmpl lhomfom and the hunts for unsolicited evanpdom My vtoHtian of 3 6 216 0 2 5 ?($� Number Occupancy e P y 3YP Stedon 7031.5 by any applicant for A permit subjects the applicant Y a civil penalty of not mart Nan fin hundred dollars (5500). ❑ 1, u realer of W pmoperty, m my employees with ages u them set compenYJon, ns Required Inspections will do the work, and the structure I, at mounted oraIrmed for sale (Sea 70W, Bu°iws an owner of and professional Cad°: The Comosar s iLicense law data not apply toe q P property who builds orimpmns downs, and who doessuch work himselfor through his awn emplayees. provided Nal such improvements are not intended aro@red forsak. It, however, Ne Wilding orimprowmenl is sold within am year of completion. the owner - builder will ban Ila burden of moving that M did not build or improve for purpose of ukJ. ❑ 1. as owner of Can prepeny, am eaclusinly Contracting with licensed rontrYmY b conatruct the project (Sec. 7000, Business and R°fesslom C°de:) The ContraemfA U. cove law does not apply as an owner of property who Wilds or improves Merton. and. who rontncu for such project withs conuanbr(a) licensed pumunl in the ContranoYs Liecam law. ❑ Iomeaemptunder See ,B&PCfm Wsmawn Owner Date WORKER'S COMPENSATION OECLARATION 1 hereby alarm under penalty of perjury one of that following declarations: ham and will maintain a CmUrIcate of COnsent to self -insure, for Worker's Comics. , An provided for by Section 3700 of the Labor Code. for the performance of the - rk for which this permit is issued. ❑ t bin and will maintain Workees Comperom lon Insurm e. As required by Schon 3700 of the later Code. for the poor...of lie wort far which lhu permit is [Acted. My Workeei Compensation bwran c Cartier and polity nu�be Cartier: S &Q—talky No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thi, section need m1 W completed If IW permit Is foram hundred dollars ($1010 or ICAs) 1 carlify that in the performance of due work for which this permit u Wood, I shall not employ any N. hoary manner se As in thecoma abject to the Wmlae Camp evedon ' Law° of California. Dale Applicant NOTICE TO APPLICANT: If, after making this Centiliter: of Exemption, you should become Aubjcn b Ne Worimrj Compensation previsions of the LAW Code, you menu ' forthwith comply with such previaiov or this permit Nall be doomed mated. CONSTRUCTION LENDING AGENCY 1 Mr by Ihar rt u a rottsuuc. agency.)for the per(ormenm of which hihans 30 7. Ch, the auk for which this pormit I. iumd (Sc. ]09'7, Civ. G) ' mi ' ndoes Name _ Lcndeh Atltlm.• U I certify that I have mad this application and Acte that the above information Is ' correct. 1 agree to comply with all city and county ordinances and sue laws nesting to Wilding construction, and hereby auharim MPrt DULL a of thin city Y Coes upon the above-mentioned property for impaction purpose, (We) agree 10 Ann, indemnify and keep harmless the City of Cupertino against j liabilities,judgments, casts and eapeves which may in my way accom against Yid City In Caanegmnce of the rum` of thY permit. ' ANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date SOURCE REGU d$ �- Re -roofs Type of Roof o5iffliture c(Applid5ingCorlbamer Dale HAZARDOUS MATERIALS DISCLOSURE Will dissimlicanlcar future Wilding a cup at same or handle hmardov material As dented by the Cupertino Municipal Code. Chapter 9.13, and the Health and Safety Cade, Sm We 25533(.)?All roofs shall be inspected prior to any roofing material being installed. [_]Y.No If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future Wilding Occupant use equipment or device which t hcnrdoon Air contaminants An dcMcd by that Bay Area Air Qualily Management all new materials for inspection. CR 0Yes @M5- 1 haw retl the hemdov materials requirements under Chopler6.95 of the Califor- nuHeslth&SafctyCade.Sn�iana U503.255JJ uW 25531.1 undauntl thnifde Wilding does ret currently have . kmken h ts re reapovinility a racily the Occupant of the req' aarO vpanry. Signature of Applicant Date rote All roof coverings to be Class '%¢" or better owner ism .got • 0 CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36216025.00 DATE ISSUED.......: 04/07/2008 RECEIPT #.........: BS000004391 REFERENCE ID # ...: 08040044 SITE ADDRESS .....: 1091 NOVEMBER DR SUBDIVISION ....... CITY ..............: CUPERTINO ._ IMPACT AREA ....... OPERATOR: patg COPY # : 1 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 177.95 --------------- 177.95 VOICE ID DESCRIPTION -------- ---------------------------- 301 ROUGH PLUMBING REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING OWNER ............: ECKSTEIN BRUCE E ADDRESS ..........: 1091 NOVEMBER DR CITY/STATE/ZIP ...: CUPERTINO CA, 95014-4129 RECEIVED FROM ....: FRANK CARDIA CONTRACTOR .......: CARDIA, FRANK L LIC # 612 COMPANY ..........: CUPERTINO PLUMBING ADDRESS ..........: 1300 DELL AVE STE C CITY/STATE/ZIP .. CAMPBELL, CA 95008 TELEPHONE ........: (408)253-0618 .FEE ID UNIT----- QUANTITY AMOUNT PD -TO -DT THIS REC- NEW BAL ---------- 1BPWATER ------------------ UNIT -------------------- 1.00 40.79 0.00 ---------- 40.79 ---------- 0.00 IBPWSVCS WATER SERVICE- 1.00 20.40 0.00 20.40 0.00 1BSEISMICR VALUATION 5,000.00 0.50 0.00 0.50 0.00 1PPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1PRREPIPE NO OF FIXTURE 1.00 10.20 0.00 10.20 0.00 1PRWHEATR UNITS 1.00 24.48 0.00 24.48 0.00 1TRAVDOC FLAT RATE 1.00 40.79 0.00 40.79 0.00 TOTAL PERMIT ---------- ---------- 177.95 0.00 ---------- 177.95 ---------- 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 177.95 --------------- 177.95 VOICE ID DESCRIPTION -------- ---------------------------- 301 ROUGH PLUMBING REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING c�oL/ CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CUPEI0INO PERMIT APPLICATION FORM 0 APN #�3 r v� / U a U(_) `P of Date: Building Address: Fee Group %09/ Owner's Name: Phone #: Qfk-�Cle_ 1CPSS Co actor: Phone #: �^ Uroi 8 (-k Pf�%YQ PtLt vnlo P 1CPRP Fax #: Contact: Fra , Phone #: 3dg ,_ 3 V P Fax #: Contractor License #: Gat- C%U 5 1BSEISMICOM Cupertino Business License #: P Job Description: 1BSEISMICR Seismic Residential Residential Commercial ❑ Valuation: V vU 1PRSEWER Green Building Check list must be completed and attached to this application. Green Building Points: 1RPSS Quantity Fee ID Fee Description Fee Group Permit Type 1PCSEWER Commercial building sewer/sanitary sewer P 1CPSS 1BPREPIPE Commercial re -pipe per fixture P 1CPRP 1PGASCOM Commercial Gas Piping System 1-4 Outlets P 1BSEISMICOM Seismic Commercial P 1BSEISMICR Seismic Residential P 1PRSEWER Residential building sewer/sanitary sewer P 1RPSS CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE FEESCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type I1PRREPIPE Residential re -pipe per fixture P 1RPRP 1BPWSVCS Water Service P 1CPWS or 1RPWS 1PPRSEWG Private Sewage Disposal System P 1PCESS Cesspool P 1BPWATER Install/alter Water Pipe, P 1BPFLKTURE Plumbing Fixture P 1PGASRES Residential Gas Piping System 1-4 Outlets P 1 BPGAS Gas Piping System 5+ Outlets P 1 PPERMITFEE Plumbing Permit Fee Issuance P 1PLMBLNCK Plumbing Plan Check P 1PLMBINSP Other Plumbing/gas Insp. P / 1TRAVDOC Travel & Documentation Fee B 1BUSLIC Business License B I V 1-` W ine� 0 0 0 • • E sigle"Farhily GreenPoint Checklist dater The GreenPoint Checklist Is based on the various green features Incorporated Into the home and is the basis for the GreanPoinl Rated program. A home can be considered green N It fulfills the prerequisites, earns at least 50 points, no meets the minimum points per category Energy (30), Indoor Air Oualltyl Heath (5), Resources (6), and Water (9). Please mmidici Build It Green for a list of qualified GreenPoint Raters 11 you are Interested In pursuing third -party verification. The green building practices listed below are described In the New Home Construction Green Building Guidelines, available at www.bullditomen.om. Build It Greed SmanSolutions From The Ground Up P P n__ n__ R EL FOUNDATION - Points Available Per Measure ❑ ❑ 1. Replace Pomand Cement in Concrete with Recycled Flyeah or Slog a. Minimum 20%Fyash or Slag D. Minimum 26% Flynn or Slag 1. Apply Optimal Value Engineering 0 1 1 1 p I i 3 ❑ 2. Use Frost-Prmected Shallow Foundation in Cold Areae C.E.C. Climate Zone 16) 0 1 3 El 3. Use Radon Resistant Construction (In At -disk Locations Only) 0 1 ❑ 4. Design end Build Sol l Pen Controls a Install Tamllte Shields d Separate All EHador Wood -to -Concrete Connections by Metal or Plastic FananorlDMiders - 0 __l— ___ 1 I o 071 ❑ h. All New Plants Have Tmnk Babe, or Stam Located At Least 38 Inches hom Foundation 0 3 Total Points Available in Foundation z8 0 C. LANDSCAPING Points Available Per Measure ❑ ❑ ❑ 1. Construct Resource-ET6clent Landscape a. No Invasive Species Listed by Cal -IPC Are Planted b. No Plant Spacles Will Require Hedging c.75%ol Plants Are Drought-iderent California Natives, Mediterranean, aOther Appropriate Specie 1. Apply Optimal Value Engineering 0 . 0 _ _ 3 D I i 3 a Place Rafters and Studs at 24 -Inch On Center Framing o. Size Dox and Window Headers for Load 2 Use FirtrSafe Landscaping Techniques 0 1 ❑ E] ❑ ❑ 3. Minimize Tud Arae in Landscape Installed by Builder A Ali Tud Will Have a Water Requirement Less than or Equal W Tad Fescue (5).6 plant facmr) d. Tud Shad Not Be Installed on Slopes Exceeding 70% a In Kaes Less than 8 Feet Wide c. Tud Is sW% of Landscaped Area (total 2 points) d. Tud is 510% of Landscaped Area (lotel4 points) p I 2 - 0 __l— ___ 1 I o p p ------- i - 1 2 �- - —_---_--r -- ❑ 4. Plant Shade Tree 0 3 2. Use Engineered Lumber S.Oroup Plants byWater Needs H drozoning) 0 1 2 ❑ E] S. Install High-Effil Irrigation Systema a System Uses Only Low+1ow Did, Bubblers, a Low -Dow Sprinklers b. System Has Smart Compilers a. Beams and Headers �}.--i 0I 2 0 _ I 1 3 ❑ 7. Incorporate Two Inches of Compost In the Top 6 to 12 Inches of Soil 0 1 3 ❑ 8, Mulch All Plantin Bede to the Greeter of 2 inches or Local Water Ordinance Requirement D 2 9. Use SD%Salvaged or Recycled -Content Materials for 50% of Non -Plant Landscape Dements 0 I 1 I t Onerrod Shand Board for SubDoor 10. RetluceU ht Pollution by Shielding Flzmm anclor Directing Light Downward 0 1 I I I a9 n 1 D. STRUCTURAL FRAME & BUILDING ENVEIAPE 0 2007 Points Available Per Measure 1. Apply Optimal Value Engineering ❑ ❑ a Place Rafters and Studs at 24 -Inch On Center Framing o. Size Dox and Window Headers for Load - 0 - 11-1 0 ❑ c. Use Only Jack and Cripple Studs Required 1a Load _ ��_ 2. Use Engineered Lumber U ) f �� )• ❑ a. Beams and Headers �}.--i 20 t] 1 -1 1 ❑ Headers InsulaWend Enghris 'K P' y P"a D 11C.0 0 _- 1 __— ❑ ❑ ❑ C. kJ or Web C. Wootl IJolsts a Web Tmsses la Floors d Wood IJose for Root Rafters e. Engineered or Finger -Jointed Studs for Vertical Applications U--iVVJ "Al d ll 0 n 2n ❑ t Onerrod Shand Board for SubDoor p - - ---, ❑ g. Oriented Strand Board for Well and Root Sheathing ` 0 1 3. Use FSC-CeNfied Wood V - ❑ a Dimensional Lumber, Studs and Timber. Minimum 40% p Z ❑ b. Dimensional Lumbar, Studs and Timber. Minimum 70% p 1 7 -- — ❑ c. Panel Produce: Minimum 40% p---�- ---�--�---' ❑ it. Panel Products: Minimum 70% p ------ - 02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4 E. EXTERIOR FINISH Points AVellable Per Measure 1. Use Re da es -CD nt (No Virgin Pinor FSGCertilyd Wood Docking0 1. Design and Install HVAC System to ACOA Manual J, D, and B Recomrrend"Dru, ENTER PROJECT NAME manual 2 S. Use Durable and Noncombustible Siding Materials 0 1 4. Sales Durable and Noncombustible coal Materiels 0 2 4. Use Solid Well Systems (Includes SIPs, ICF4 6 Any Non.Stick Fmme Aeaembly) F. INSULATION to Water Heater ❑ e. Floors 0 —0 V 2 --2 ❑ b. Wella S. Ina"Moll of Insulation Installation before Applying Drywall 2- 1 ❑ c. Rook D 2 2 S. Reduce Pollution Entering the Home from the Sol ❑ e. Install HVAC Unlet and Ductwork within Conditioned Space ❑ A Tighty Seal the Nr Bander between Gauge and Living Area D ❑ to Use Duct Mastic on All Duct Joints and Seams ❑ to Install Small Exhaust Fan OR Build a Detached Gems D 1 _ 0 Lj S. Design Energy Heels on Trustees (76% of Attic Inwletlon Height M Oulal Edge of Exterior WM 0 1 _ 0 7. Doolifin Roof Threaten, to Accommodate Duetwork ' 0 1 0 1 It Use Recycled -Content Stell Studs for e0% of Interior Wall Framing 0 6. Install High Efficiency HVAC Filter (MERV 6v) 1 71 9. Thermal Mesa Welly 5164nch Drywall on All Interim Walls or Wells Weighing more than 40 Well D 1 0 10. Insall Overhangs and Outlet using CSA Standerde ❑ s Minimum 18Inch Overhangs and Guiana a 0 _ 1 ❑ b. Minimum 244nch Overhangs and Gumns 0 1 D E. EXTERIOR FINISH Points AVellable Per Measure 1. Use Re da es -CD nt (No Virgin Pinor FSGCertilyd Wood Docking0 1. Design and Install HVAC System to ACOA Manual J, D, and B Recomrrend"Dru, 2 2. Inaal1 a Raln Screen Wall System D 2 S. Use Durable and Noncombustible Siding Materials 0 1 4. Sales Durable and Noncombustible coal Materiels 0 2 Total Poime Amllebie In E486M Finish.7 0 F. INSULATION to Water Heater Points Available Per Measure 1. Insall Insulation with 75% Recycled Content ❑ s Wells and/or Floor ❑ b. Cemns --0-- 1 2. Install Insulation that le Low-Emlt6ng (Certlfied Section 0105D) ❑ a. WeIIe andlor Floor ❑ b. Latina 0 1 S. Ina"Moll of Insulation Installation before Applying Drywall 0 1 1. Distribute Domestic Hot Water Emclal (Maximum 7 Pomo) . ❑ a. Insulate Hot Water Pipes from Water Heeler to (Itchen ❑ to Insulate AO Hot Water Pipes ❑ c. Use Engineered Pal Piping ❑ d. Use Empneen d Parallel Piping with Dement Control Omulal Loop ❑ e. Use Strummed Plumbing with Demand Controlled Circulation Loop D_ 1 _ 1 0 1 7 0 _ .. 1 . _ _ - - 2 Pnim@ A.I.N. In Plombino v Total 121 D H. HEATING, VENTILATION @ AIR CONDITIONINO Poll Available Per Measure 1. Design and Install HVAC System to ACOA Manual J, D, and B Recomrrend"Dru, 0 4 I 2. Install Sealed Combustion Unit ' ❑ e. Furnaces ❑ to Water Heater 0 2 5, Install Zoned, Hydronic Radiant Heading with Stab Edge Insulation 0 1 1 Lj 4. Install High Efficiency Air Conditioning with Environmentally Ruponalble Refrigerant 0 1 5. Design and Install Effective DYClwork ❑ e. Install HVAC Unlet and Ductwork within Conditioned Space 0 3 ❑ to Use Duct Mastic on All Duct Joints and Seams _ 0 ❑ c. Install Ductwork under Attic Insulation (Burial Ducts) _ 0 ❑ d. Press= Balance the Ductwork System _ 0 ❑ e. Protecl Duct during Consul and Clean All Ducts beta@ Oreupanry 0 1 6. Install High Efficiency HVAC Filter (MERV 6v) 0 1 ❑ 7. Dont Install Fireplace or Install Sealed Gas Fireplaces with Efficiency Rading Not Less Than 60% 0 1 using CSA Standerde B. Install Effective Exhaust Systems in Bathrooms and atchans , ❑ a. Install ENERGY STAR Bathroom Fens Vended to the Outside D ❑ to All Bathroom Fans Ar on Timer or Humldstel 0 - _❑ El c. Install Kitchen Range Hood Varied to the Outside 0 1 s. Install Mechanical Ventilation System for Cooling (Medmum 4 Points) ❑ L Install ENERGY STAR Caging Fans s Light (Its In Uvarg Amu 6 Bedrooms_ 0 F1 b, Insist Whole House Fan with Variable Speeds 0 ❑ c. Automatically Controlled Integrated System _ D ❑ d. Automatically Controlled Integrated System whit Variable Speed Control 0 3 10. Install Mechanical Fresh Air Ventilation System (Maximum 5 Paints) ❑ a. Any Whole House Ventilation System That Meats ASHRAE 622 0 _ _ _ r 2 ❑ b. must All Hell Exchanger that meets ASHRAE 622 0 ] 2 11. Install Carbon Monoxide Alarms) 0 1 02007 Build It Green Single Family GreartPoint Checklist 2007 Version Page 2 of 4 1 i 0 • J. BUIIAING PERFORMANCE Points Available Per Measure 1. Diagnostic Evaluations . ❑ a. House Passes Blower Door Test ❑ b. House Passes Combustion Safety Backlash Test ❑ ❑ ❑ ❑ 0_ _ 0 1 2Deslgn and Build High Performance Homes - %above Title 24- minimum 15% Required 0 >_30 ❑ 3. House Obtains ENERGY STAR with Indoor Air Package Certification. Firm Measure (Total 45 pointe; mad comment) 0 5 2 Total Available Points In Building Performance = 39 0 E. FINISHES Points Available Per Measure ❑ ❑ ❑ ❑ 1. Design Entryways W Reduce Tracked in Contaminants D 1 0 ❑ ❑ 2. Use Low-VOC or Zero-VOC Paint (Maximum 3 Points) a.Low-VOC Interior WeIVCefing Paints (<50 gill VOCs(Flat) and <150 API VOCs(Non-Flay) b. Zaro-VOC: Interior WaIDCellin Paints (d 0 VOCs (Flat) L 0 D 0 3 2 Thermal Mese Floors: Floor Covering Other Nan Carpet on SD% or More of Concrete Floors ❑ s. Use Low VOC, Wmsr-Based Wood Frnishes 1Q 0 BPI VOCs) 0 2 ! ❑ 4. Use Low.VOC Caulk and Construction Adhesives (<70 gill VOCs) for All Adhesives 0 2 ❑ 5. Use Re olad-Content Paint D ! ! 1 I ❑ ❑ ❑ ❑ ❑ S. Use Environmentally Preferable Materiels for Interior Finish: A) FBC-Certifistl Wood, B) Reclaimed, C) Rapidly Renewable, 0) Recycled -Content or E) FlngerJolnted e Cabins%(5D% Minimum) b. Interior Trim (50% Minimum) c. Shelving (50% Minimum) d. Doors (50% Minimum) e. Counts (50%Minimum) 0 0 p p 7 1 1 0 ] ❑ ❑ ❑ ❑ 7. Reduce Formaldehyde In Interior Finish (CA Section 0135D) . a. Subnoor s StabTreads(50%Minimum) In. Cabinets &Coun%nop(50%Minimum) c. Interior Trim (50% Minimum) d. Shelving 50%Minimum 0 ] 0_-7--1---r-- _ 0 0 1 I ❑ & After Installation of Finalists, Test of Indoor Air Shows Formaldehyde Level Q7pplb 0 ! 3 Total Available Prince In Freres =211 0 1 L. FLOORING. Points Avallable Per Measure ❑ ❑ ❑ ❑ 1. Use Environmentally Preferable Flooring: A) FSC -Certified Wood, B) Reclaimed or Rennisha7, C) Rapidly Renewable, D) Recycled- Content, E) Exposed Concrete Flooring Adhesives Must Have de gpl VOCs a. Minimum 15%o Floor Area b. Minimum 30% of Floor Area c. Minimum 50% of Floor Area J. Minimum 75% of Floor Area 0 1 ! I ! ! 1 0 0 L 0 ❑ 2 Thermal Mese Floors: Floor Covering Other Nan Carpet on SD% or More of Concrete Floors 0 1 ❑ 3. Flooring Meets Section 01350 or CRI Green Label Plus Requirements (50% Minimum) 0 I 2 I Total Available Points In Roorino a 71 o I M. APPLIANCES AND LIGHTING Points Available Par (Measure ❑ ❑ 1. Install Water and Energy Efficient Dishwasher a ENERGY STAR (total 1 pony b. Dishwasher Uses No More than 6.5 Gallon le total 2points) 0 0 1 ! I ! ! 1 ❑ ❑ 2. Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less a. Meets Energy She and DEE Tier requirements(modifiDd energy factor 2.0, Water Factor 6.0)(total 3 points) b. Meets Energy She and DEE Tier 3 requirements (modified energy factor 21, Witter Factor 4.5 a less) (must S nts 0 1 0 _ _2 _ I 2 ❑ ❑ 3. Install ENERGY STAR Refrigerator a. ENERGY STAR Qualified & <25 Cubic Feet Capacity b. ENERGY STAR Qualified & <20 Cubic Feet Capacity 0 0 1 1. Install Buill4n Recycling Center 0 ❑ ❑ a BuIIHn Recycling Center b. Built -In Composting Center p 0 3. Community Design Measures & Local Priorities: See the Community Planning A Design section in Chapter 4 at the New Home Guidelines for • meazums. Man Mum at2D points for Suggested measures. Local requirements may also be listed here. 0 2007 Build It Green Single Famlly GreenPoint Checklist 2007 Version Page 3 04 Enter description hen, and ardor points mate in is meaaun in appropriate wupories to the right. Enter description here, and ental points wallade her messu e in appropriate caugorin to the right. Enter daacrllaten here, and enter points auallaWe for manure In appropriate categories to he right. Enter dacrlpaon Were, antl moor points analede far manure In appropriate categories to the right. 4. Innovation: List Innovative measures that meet the green building objectives of the Guidelines. Enter up to a measure Total Available Points In Specific Categodes' Prolaact has not yet mot the following recommended minimum roquirements:/�—_}� - Total Project Score of At Least 50 Points �J - Required measures: -Ma: 50% waste diversion by weight -J2: 1501. above 7 ba 24 -NI: Incorporate Green Point Rated Checklist into blueprints - Minimum points in specirrc categories: -Energy (30 points) -SAQ/Health (5 points) -Resources (6 points) -Water (9 points) 0 0 0 0 D 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 D 0 0 0 D 0 0 0 0 1 0 J 0 0 u D n 0 0 0 0 0 0 0 0 42+ 1 66+ 43+ • C� J 02007 Build It Green Singla Family GreenPohl Checklist 2Dg7 Version Page 4 of 4 CITY OF +UPERTINO 11 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department JOB ADDRESS: (� /Y0\2tn PERMIT # OoLtLk OWNER'S NAME: fug PHONE # /6 -- 4,38 g GENERAL CONTRACTOR: FAX # I am not using any subcontractors: /" � �+'' 7- Og Sign a Date Please check applicable subcontractors and complete the following information: • Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile • Owner/ Contractor Signature Date